{"title":"Advancing research and policy in climate and health in the Nordic countries: Key challenges and opportunities for future action.","authors":"Shilpa Rao","doi":"10.1177/14034948241296193","DOIUrl":"10.1177/14034948241296193","url":null,"abstract":"<p><strong>Aim: </strong>This editorial presents state of the art developments in research and policy in the newly emerging field of climate and health and examines the gaps in research, the relevance of Nordic research in a global context, and the need to place the climate-health agenda in the policy space.</p><p><strong>Methods: </strong>We use a set of articles from the Special Issue on 'Climate change and health in the Nordic countries' in this journal to understand current research in climate and health. We identify three emerging areas that characterize the current focus of research: modelling climate change-induced exposures; health cross-linkages of the climate health agenda and targeted communication. On linking the ongoing research with several recent policies and projects within the EU and Nordic countries, we identify vital questions where future research needs to concentrate and discuss the challenges associated with this.</p><p><strong>Results: </strong>We identify three key questions related to interaction, vulnerable groups and equitable adaptation that will be crucial to future risk. We highlight a need for integrated study designs and innovative data analysis tools to help answer these questions.</p><p><strong>Conclusion: </strong>\u0000 <b>We conclude with proposing a path forward for the 'Climate and Health' research and policy agenda in the years to come.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"115-118"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shilpa Rao, Kristin Aunan, Isabelle Budin-Ljøsne, Francesco Di Ruscio, Antonio Gasparrini, Pierre Masselot, Matteo Pinna Pintor, Zuzana Nordeng, Reija Ruuhela, Bernadette Kumar
{"title":"The need for health equitable climate adaptation policies in Northern Europe.","authors":"Shilpa Rao, Kristin Aunan, Isabelle Budin-Ljøsne, Francesco Di Ruscio, Antonio Gasparrini, Pierre Masselot, Matteo Pinna Pintor, Zuzana Nordeng, Reija Ruuhela, Bernadette Kumar","doi":"10.1177/14034948241290074","DOIUrl":"10.1177/14034948241290074","url":null,"abstract":"<p><p>Socioeconomic conditions remain an important factor in determining health outcomes in Northern Europe. In this commentary, we argue for evidence-based temperature-related climate adaptation policies in Northern Europe that account for disparities in socioeconomic conditions and aim at universal health coverage. We highlight the role of spatial and occupational disparities in urban areas that can be important factors in increased physical and mental health impacts related to heat and cold. We further highlight how these factors interplay with exposure to air pollution and access to green areas and worsen health conditions. Adaptation to changing climatic conditions requires both physiological acclimatization and behavioral adaptation, both of which are difficult to assess for socioeconomically deprived communities. We argue for more equitable climate adaptation strategies that include i) better integration of health in climate change adaptation plans; ii) building climate resilient communities, and iii) integrated surveillance and health systems. These actions could be vital in spearheading research in new cross-cutting areas like climate change, migration, and health.</p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"215-218"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Isabelle Budin-Ljøsne, Zuzana Nordeng, Per Everhard Schwarze, Shilpa Rao
{"title":"Linking climate change adaptation and public health: perspectives of Norwegian policymakers.","authors":"Isabelle Budin-Ljøsne, Zuzana Nordeng, Per Everhard Schwarze, Shilpa Rao","doi":"10.1177/14034948241229486","DOIUrl":"10.1177/14034948241229486","url":null,"abstract":"<p><strong>Aims: </strong>To explore the perspectives of selected Norwegian climate and health policymakers working at national and municipality level regarding how health is accounted for in climate change adaptation plans.</p><p><strong>Methods: </strong>Semi-structured digital interviews were conducted with representatives from eight municipalities participating in a national network for climate change adaptation, one political unit and five national public administrations working in climate, health, environment, preparedness, and civil protection.</p><p><strong>Results: </strong>Municipalities coordinate the development of climate change adaptation plans with support from key national actors. Although municipalities were experienced in preparing for extreme climate events and securing infrastructure, limited consideration was given to health in the climate change adaptation work. Such integration was hindered by lack of resources and knowledge regarding what to do, and lack of collaboration between municipality sectors. To connect climate change adaptation and health better, the representatives suggested providing evidence-based information regarding health impacts of climate change, developing concrete tools including warning systems, and implementing regional, national, and international projects to map the impact of climate change and raise capacity. The representatives called for more stringent national guidelines for the integration of health in climate change adaptation, and pinpointed that lessons learnt from the COVID-19 pandemic will enable municipalities to be better prepared and more adaptable in the future.</p><p><strong>Conclusions: </strong>\u0000 <b>\u0000 <i>Governmental authorities should provide more concrete guidance regarding the integration of health in climate change adaptation plans. Public health authorities have a central role to play in supporting such endeavours.</i>\u0000 </b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"125-133"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ola Løkken Nordrum, Ingrid Mobacke, Tuija MäNnistö, Martin Schønemann-Lund, Hjalti Már Björnsson, Lisbet Sviland
{"title":"The climate crisis is a health crisis: A Statement by Nordic Doctors for Planetary Health and Climate Action.","authors":"Ola Løkken Nordrum, Ingrid Mobacke, Tuija MäNnistö, Martin Schønemann-Lund, Hjalti Már Björnsson, Lisbet Sviland","doi":"10.1177/14034948241302923","DOIUrl":"10.1177/14034948241302923","url":null,"abstract":"","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":"53 2","pages":"223-224"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liliana Vázquez Fernández, Alfonso Diz-Lois Palomares, Ana M Vicedo Cabrera, Birgitte Freiesleben De Blasio, Francesco Di Ruscio, Torbjørn Wisløff, Shilpa Rao
{"title":"Short-term association between air temperature and mortality in seven cities in Norway: A time series analysis.","authors":"Liliana Vázquez Fernández, Alfonso Diz-Lois Palomares, Ana M Vicedo Cabrera, Birgitte Freiesleben De Blasio, Francesco Di Ruscio, Torbjørn Wisløff, Shilpa Rao","doi":"10.1177/14034948241233359","DOIUrl":"10.1177/14034948241233359","url":null,"abstract":"<p><strong>Background: </strong>The association between ambient air temperature and mortality has not been assessed in Norway. This study aimed to quantify for seven Norwegian cities (Oslo, Bergen, Stavanger, Drammen, Fredrikstad, Trondheim and Tromsø) the non-accidental, cardiovascular and respiratory diseases mortality burden due to non-optimal ambient temperatures.</p><p><strong>Methods: </strong>We used a historical daily dataset (1996-2018) to perform city-specific analyses with a distributed lag non-linear model with 14 days of lag, and pooled results in a multivariate meta-regression. We calculated attributable deaths for heat and cold, defined as days with temperatures above and below the city-specific optimum temperature. We further divided temperatures into moderate and extreme using cut-offs at the 1st and 99th percentiles.</p><p><strong>Results: </strong>We observed that 5.3% (95% confidence interval (CI) 2.0-8.3) of the non-accidental related deaths, 11.8% (95% CI 6.4-16.4) of the cardiovascular and 5.9% (95% CI -4.0 to 14.3) of the respiratory were attributable to non-optimal temperatures. Notable variations were found between cities and subgroups stratified by sex and age. The mortality burden related to cold dominated in all three health outcomes (5.1%, 2.0-8.1, 11.4%, 6.0-15.4, and 5.1%, -5.5 to 13.8 respectively). Heat had a more pronounced effect on the burden of respiratory deaths (0.9%, 0.2-1.0). Extreme cold accounted for 0.2% of non-accidental deaths and 0.3% of cardiovascular and respiratory deaths, while extreme heat contributed to 0.2% of non-accidental and to 0.3% of respiratory deaths.</p><p><strong>Conclusions: </strong>\u0000 <b>Most of the burden could be attributed to the contribution of moderate cold. This evidence has significant implications for enhancing public-health policies to better address health consequences in the Norwegian setting.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"134-141"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tzu Tung Chen, Yoonhee Kim, Fredrik Charpentier Ljungqvist, Jerker Jarsjö, Jenny C Hesson, Hans W Linderholm
{"title":"Climate and malaria: modeling non-linear dynamics in the Nordic countries during the 18th and 19th centuries.","authors":"Tzu Tung Chen, Yoonhee Kim, Fredrik Charpentier Ljungqvist, Jerker Jarsjö, Jenny C Hesson, Hans W Linderholm","doi":"10.1177/14034948251320865","DOIUrl":"https://doi.org/10.1177/14034948251320865","url":null,"abstract":"<p><strong>Aims: </strong>Until the late 19th century, <i>Plasmodium vivax</i> malaria was endemic in most of Europe including in the Nordic countries. In Denmark, Finland, and Sweden, the fluctuations in malaria cases and malaria-attributed deaths are known to have been associated with weather conditions, in particular with mean summer temperature variations. However, to what extent other environmental factors could have increased or decreased the risk of malaria has not previously been evaluated using historical records.</p><p><strong>Methods: </strong>In this study, we illustrate the non-linear association between different environmental variables (temperature, precipitation, and sea-level variations) and symptom-based malaria (case and death) data, using the quasi-Poisson distributed lag non-linear model. The robustness of the model results was examined through sensitivity analysis.</p><p><strong>Results: </strong>The modeling results showed that the risk associated with temperature increased by ∼25% in Denmark and by ∼67% in Sweden and Finland, with a mean summer temperature increase from 16°C to 18°C, was highest at 1-2 lagged years. Furthermore, average precipitation could have a noticeable effect on the malaria risk in Sweden and Finland, but this effect was not observed in Denmark. Environmental perturbations associated with extreme sea levels (>99.7th percentile or <0.1th percentile), including subsequent saltwater intrusion, could lead to increasing malaria risk in low-lying coastal areas.</p><p><strong>Conclusions: </strong>\u0000 <b>The historical evidence and modeling results suggest that specific weather conditions and extreme events have substantial impacts on malaria in temperate regions.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":"53 2","pages":"162-171"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zuzana Nordeng, Hedi K Kriit, Helen Poltimäe, Kristin Aunan, Miriam S Dahl, Marija Jevtic, Vlatka Matkovic, Gunnell Sandanger, Hans Orru
{"title":"Valuation and perception of the costs of climate change on health.","authors":"Zuzana Nordeng, Hedi K Kriit, Helen Poltimäe, Kristin Aunan, Miriam S Dahl, Marija Jevtic, Vlatka Matkovic, Gunnell Sandanger, Hans Orru","doi":"10.1177/14034948241247614","DOIUrl":"10.1177/14034948241247614","url":null,"abstract":"<p><strong>Background and aims: </strong>Climate change affects our societies and lives through our economies, our livelihoods, and our health. Economic losses of climate change are estimated at $23 trillion, largely through externalities due to premature mortality, healthcare expenditure, and health-related work losses. Even if there are established methods to quantify the health economic burden, there is limited information on how people perceive this information. The current study aimed to examine different health cost evaluation methods and observe perceptions of stakeholders in the climate change context.</p><p><strong>Method: </strong>The participatory research approach of the World Café with 41 participants was applied to explore four topics associated with valuing the costs of climate change. The data were analyzed following an inductive approach.</p><p><strong>Results: </strong>Despite the willingness-to-pay approach being widely applied, many experts see actual healthcare costs as a more explicit indicator of costs; however, this approach might underestimate actual costs. Participants experienced difficulties accepting and understanding cost estimates that indicated very high externalities as a percentage of gross domestic product. The cost-effectiveness of mitigation and adaptation measures was also challenged by a concern that while the costs of such measures are incurred now, the benefits do not come to fruition until later, for example, when building bike lanes or dams.</p><p><strong>Conclusions: </strong>Policies should favor environmentally friendly activities such as making cycling more convenient in cities with the health benefits presented in monetary terms, while limiting car driving. Moreover, the public might better understand the costs of climate change via tools that map how solutions influence different sectors and outlining the costs in evaluating the benefits for health and the environment.</p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"149-155"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impacts of temperature and solar radiation changes in northern Europe on key population health behaviors: a scoping review of reviews.","authors":"Heini Wennman, Timo Partonen","doi":"10.1177/14034948231216909","DOIUrl":"10.1177/14034948231216909","url":null,"abstract":"<p><strong>Aim: </strong>Climate change threatens health directly as well as indirectly through impacts on health-related behaviors. Physical activity, nutrition and sleep are key health-related behaviors for population health. We aimed at elucidating the impacts of climate change which emerge gradually on these three key health-related behaviors, particularly focusing on scenarios and projections relevant to people living in the northern Europe.</p><p><strong>Methods: </strong>We conducted a systematic literature search in three different databases in January 2023 to identify English language review articles summarizing the effects of climate change on either physical activity, nutrition, sleep, or their combination.</p><p><strong>Results: </strong>We identified 15 review articles on the topic. Data on climate change impacts on nutrition and sleep were sparse, and those on physical activity were heterogeneous. The climate in northern Europe will become warmer and sunnier in summer as well as warmer and darker in winter, which will probably increase the level of physical activity, but decrease the consumption of fruits and vegetables, as well as increase the occurrence of sleep disturbances in a population.</p><p><strong>Conclusions: </strong>\u0000 <b>The anticipated changes in physical activity, nutrition and sleep driven by climate change influence population health and call for grass-roots action plans for adaptation.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"184-194"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pedestrian wintertime slip and fall injuries-effectiveness of weather warning service in prevention.","authors":"Reija Ruuhela, Marjo Hippi, Sari Hartonen","doi":"10.1177/14034948241253673","DOIUrl":"10.1177/14034948241253673","url":null,"abstract":"<p><strong>Background and aim: </strong>In climates with wintry conditions, slip and fall injuries of pedestrians during wintertime can result in high healthcare and societal costs. The aim of this study was to evaluate the effectiveness of early warnings about slipperiness in preventing such injuries in Finland. Since 2004, the Finnish Meteorological Institute (FMI) has been providing a weather service for pedestrians, which has been developed continuously over time.</p><p><strong>Data and methods: </strong>Time series of pedestrian slip and fall injuries in commuting on foot in the 19 regions of Finland in 2005-2022 was obtained from the Finnish Workers' Compensation Center and analysed for trends. We also analysed daily warnings about slippery sidewalks from the FMI archives for the period 2011-2022. To identify steps in the service chain that require improvement, we conducted a weather service chain analysis (WSCA) based on a slip and fall accident storyline.</p><p><strong>Results: </strong>There was no significant trend in the number of slipping injuries during the study period. The exposure of the Finnish population to slippery conditions varies according to the climate of the region and characteristics of the winters. We found that the responses of the users of the warning information may be inadequate.</p><p><strong>Conclusions: </strong>\u0000 <b>Changes in the behaviour of individuals and more efficient winter maintenance of sidewalks are required. Furthermore, it is necessary to promote the role and safety of walking in the planning of traffic systems and urban planning. Further improvements to the pedestrian weather service are needed as well.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"142-148"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Modeling impacts of traffic, air pollution, and weather conditions on cardiopulmonary disease mortality.","authors":"Cong Cao, Jan Morten Dyrstad, Colin P Green","doi":"10.1177/14034948241290852","DOIUrl":"10.1177/14034948241290852","url":null,"abstract":"<p><strong>Aims: </strong>Cardiopulmonary disease (CPD) is a leading cause of death worldwide. Increasing evidence shows that air pollution and exposure to weather conditions have important contributory roles. Understanding the interaction of these factors is difficult due to the complexity of the relationship between CPD, air pollution, and environmental factors.</p><p><strong>Methods: </strong>This paper uses regression models and machine learning approaches to explore these relationships, and investigate whether meteorological factors and air pollution have a synergistic effect on CPD. We use daily data from 2009-2018 from four cities representing the heterogenous climate conditions in Norway: the far north, the west coast, mid-Norway, and the south-east.</p><p><strong>Results: </strong>We demonstrate the importance of the interaction between weather and air pollution associated with higher CPD mortality, as is exposure to air pollution in the form of <math><mrow><mi>NOx</mi><mspace></mspace><mi>and</mi></mrow></math>particulate matter. This impact is seasonal. Traffic is also positively related to CPD mortality, which may be caused indirectly through increased pollution. We demonstrate that machine learning outperforms regression models in terms of the accuracy of predicting CPD mortality.</p><p><strong>Conclusions: </strong>\u0000 <b>The inclusion of rich lagged structures and interactions between environmental factors are both important but can lead to overfitting of traditional models; since these cities are not large cities by international standards, it is surprising that environmental factors have such obvious impacts on CPD mortality. CPD mortality shows a clear negative trend, implying an improvement in the public health situation.</b>\u0000 </p>","PeriodicalId":49568,"journal":{"name":"Scandinavian Journal of Public Health","volume":" ","pages":"119-124"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}